The proposed project will examine the use of immersive virtual reality technology as an intervention tool for HIV Prevention with adolescents. Adolescents are at risk for contracting HIV. Affect dysregulation is common among adolescents. Research has demonstrated connections between poor affect management abilities and risky sexual behavior among adolescents. This research suggests that the ability to regulate one's emotions is key to avoiding risk behaviors and that adolescents are at greater risk for poor affect management skills. Fortunately, these skills can be taught via teaching and modeling, making them an excellent target for intervention, which has previously been approached through role-playing. Immersive virtual reality offers many advantages over group based role-plays, used in HIV prevention interventions for adolescents, in its ability to simulate real-world environments and extend the impact of HIV prevention interventions. Similar to its use in PTSD, immersive virtual reality is a promising technology for giving teens the opportunity to practice using effective affect regulation skills in a highly realistic environment. Additional benefits of this technology will likely be increased engagement and retention in HIV prevention interventions among young adolescents. The overall aims of Phase I and Phase II of this proposed STTR project are to develop and refine a virtual reality environment for adolescents targeting affect management. In Phase I, the research team will develop and refine an immersive virtual environment that will elicit affect in a high-risk situation. The final immersive virtual reality environments (completed in Phase II) can be used by health promotion interventionists in conjunction with an HIV prevention intervention manual as a means to elicit affect and provide adolescents with a "real world" environment in which to practice emotion regulation skills related to substance use and HIV prevention. These aims will be achieved through the collaboration of researchers at Rhode Island Hospital/Brown and Virtually Better, a small business that specializes in creating immersive virtual reality environments for clinical use. This tool will represent a significant advance in the way in which affect regulation skills are practiced and honed, currently achieved via role plays or imaginal exposure, by increasing the salience of cues used to elicit affect, thus making it highly marketable to interventionists, schools, and mental health clinicians. Public Health Significance: (1) Examine whether immersive virtual reality technology provides an enhanced environment for adolescents to practice emotion regulation skills and negotiate safer sexual behavior. (2) Provide adolescent HIV prevention interventions with an additional tool to target sexual risk reduction. PUBLIC HEALTH RELEVANCE: This project would design and develop an immersive virtual reality environment for adolescents with mental health problems to provide realistic scenarios with which adolescents can practice managing affect associated with cues to engage in risk behaviors.